膜解剖指导下精准手术理念在腹腔镜胃癌根治术的临床应用

doi:10.3969/j.issn.2095-378X.2025.01.012

摘要/Abstract

摘要： 目的　探究膜解剖指导精确手术理念在腹腔镜胃癌根治术中的临床效果。方法　选取广西壮族自治区贵港市人民医院自2022年1月—2024年1月收治的98例进展期胃癌患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各49例。对照组行常规腹腔镜胃癌根治术治疗,观察组行膜解剖理论指导下腹腔镜胃癌根治术治疗,对比两组患者手术时间、术中出血量、淋巴结清扫数量、术后首次排气时间、住院时间、术后疼痛程度评分[采用视觉模拟评分法（visual analogue scale, VAS）评定]以及术后并发症发生率。结果　观察组患者手术时间长于对照组,术中出血量低于对照组,淋巴结清扫数量多于对照组,术后首次排气时间、住院时间均短于对照组,观察组患者术后VAS评分、并发症发生率均低于对照组,两组间比较,差异均具有统计学意义（P<0.05）。结论　膜解剖指导下精准手术理念在腹腔镜胃癌根治术的临床应用效果显著,可以显著减少术中出血,降低术后疼痛程度和并发症发生率,并促进患者术后恢复,值得应用和推广。

关键词: 膜解剖指导下精准手术理念, 胃癌, 腹腔镜胃癌根治术, 临床效果

Abstract: Objective To investigate the clinical effect of membrane anatomy guided precise surgical concept in laparoscopic radical gastrectomy for gastric cancer. Methods A total of 98 patients with advanced gastric cancer admitted to Guigang People's Hospital in Guangxi Zhuang Autonomous Region from January 2022 to January 2024 were selected as study subjects. They were randomly divided into a control group and an observation group, with 49 patients in each group. The control group received conventional laparoscopic radical gastrectomy treatment, while the observation group received laparoscopic radical gastrectomy treatment guided by membrane anatomy theory. The surgical time, intraoperative blood loss, number of lymph node dissection, first postoperative exhaust time, hospitalization time, postoperative pain score [by visual analogue scale （VAS）], and incidence of postoperative complications were compared between the two groups of patients. Results Compared with the control group, the surgery time of the observation group patients was longer, the intraoperative blood loss was lower, the number of lymph node dissections was higher, the first postoperative exhaust time and hospitalization time were shorter, the VAS score and incidence of complications were lower; the differences between the two groups were all statistically significant （P<0.05）. Conclusion The precise surgical concept guided by membrane anatomy has a remarkable effect on laparoscopic radical gastrectomy for gastric cancer, which can significantly reduce intraoperative bleeding, postoperative pain, and incidence of complications, and promote postoperative recovery of patients. It is worth applying and promoting.

Key words: Precision surgical concept under the guidance of membrane anatomy, Gastric cancer, Laparoscopic radical gastrectomy for gastric cancer, Clinical effectiveness

中图分类号:

R735.2

郑逸川. 膜解剖指导下精准手术理念在腹腔镜胃癌根治术的临床应用[J]. 外科研究与新技术（中英文）, 2025, 14(1): 52-56.

ZHENG Yichuan. Clinical application of precise surgical concept guided by membrane anatomy in laparoscopic radical gastrectomy for gastric cancer[J]. Surgical Research and New Technique, 2025, 14(1): 52-56.

参考文献

[1] 翁正辉. 不同入路腹腔镜胃癌根治术对患者胃肠功能及血清炎性因子水平的影响[J]. 外科研究与新技术(中英文),2024,13(1):61-63.
[2] 郑志华,刘江睿,施凉潘,等. 腹腔镜下膜解剖胃癌D2联合CME根治术治疗胃癌的疗效[J]. 中外医疗,2023,42(36):5-8.
[3] 夏扣柱,张健,窦豆,等. 腹腔镜辅助胃癌D2根治术治疗进展期胃癌对比观察[J]. 外科研究与新技术(中英文),2021,10(2):104-106.
[4] 林明强,汪家航. 腹腔镜胃癌根治术对老年胃癌患者围手术期指标及复发情况的影响[J]. 中国医疗器械信息,2023,29(21):113-115.
[5] 潘建海,李中敏,华健灿. 腹腔镜胃癌根治术中腹腔灌注治疗进展期胃癌的疗效观察[J]. 外科研究与新技术(中英文),2020,9(1):17-19.
[6] Yen HH, Yeh CC, Lai IR.Laparoscopic versus open distal gastrectomy for elderly patients with advanced gastric cancer: a retrospective comparative study[J]. World J Surg Oncol, 2022, 20(1): 355.
[7] 许诚,牛云霞,陈治,等. 腹腔镜胃癌根治术对老年早期胃癌患者血清肿瘤标志物、炎性因子的影响[J]. 癌症进展,2023,21(15):1730-1733.
[8] 张丽敏,聂培鹤,季雪莲,等. ERAS结合麻醉恢复室护理应用于腹腔镜胃癌根治术[J]. 潍坊医学院学报,2023,45(3):192-194.
[9] Kinoshita T, Sato R, Akimoto E, et al.Reduction in postoperative complications by robotic surgery: a case-control study of robotic versus conventional laparoscopic surgery for gastric cancer[J]. Surg Endosc, 2022, 36(3): 1989-1998.
[10] 王刚. 腹腔镜下胃癌根治术与传统开腹手术治疗进展期胃癌的效果[J]. 吉林医学,2023,44(5):1213-1215.
[11] Bracale U, Peltrini R, Corcione F."Impact of neoadjuvant therapy followed by laparoscopic radical gastrectomy with D2 lymph node dissection in Western population: a multi‐institutional propensity score matched study"—Authors' reply[J]. J Surg Oncol, 2022, 125(8): 1338-1339.
[12] Tian Y, Lin Y, Sun C, et al.Comparison of short-term efficacy and safety between total robotic and total 3D laparoscopic distal radical gastrectomy for gastric cancer in Enhanced Recovery After Surgery (ERAS) protocol: a propensity score matching study[J]. J Robot Surg, 2023, 17(3): 1151-1158.
[13] 薛然荣,孙明明,张云. 基于危害分析临界控制点联合故障模式和效应分析的手术室护理在腹腔镜胃癌根治术患者中的应用[J]. 肿瘤基础与临床,2023,36(6):534-537.

[1]	杨远峰, 张鸿明. 经自然腔道取标本手术治疗内痔伴直肠黏膜内脱垂的疗效及安全性[J]. 外科研究与新技术（中英文）, 2025, 14(1): 57-60.
[2]	周杰彬, 董瑜, 罗向东. 输尿管软镜钬激光碎石术治疗肾结石的效果研究[J]. 外科研究与新技术（中英文）, 2025, 14(1): 69-72.
[3]	王剑. 改良胃空肠Roux-en-Y吻合术对胃癌患者术后胃肠功能的影响研究[J]. 外科研究与新技术（中英文）, 2024, 13(4): 334-337.
[4]	翁正辉. 不同入路腹腔镜胃癌根治术对患者胃肠功能及血清炎性因子水平的影响[J]. 外科研究与新技术（中英文）, 2024, 13(1): 61-63.
[5]	王盼, 杨秀春. 结直肠癌患者应用腹腔镜行根治术的临床效果观察[J]. 外科研究与新技术, 2023, 12(1): 10-13.
[6]	李庆, 徐芬, 雷浪, 李里香, 郝华. 5-脂加氧酶在胃癌中的表达与环氧化酶-2和甲酰肽受体2的关系及其临床意义[J]. 外科研究与新技术, 2022, 11(4): 232-237.
[7]	谢庆国, 孙素花. 舒芬太尼联合右美托咪定对胃癌/结直肠癌根治患者术后镇痛及呼吸的影响[J]. 外科研究与新技术, 2022, 11(2): 97-100.
[8]	李新星, 胡志前. 腹腔镜和机器人在胃癌微创手术中的发展[J]. 外科研究与新技术, 2021, 10(3): 157-161.
[9]	夏扣柱, 张健, 窦豆, 徐明. 腹腔镜辅助胃癌D2根治术治疗进展期胃癌对比观察[J]. 外科研究与新技术, 2021, 10(2): 104-106.
[10]	笪波, 徐文海. 腹腔镜疝修补术治疗成人腹股沟疝的临床疗效观察[J]. 外科研究与新技术, 2021, 10(1): 19-21.
[11]	潘建海, 李中敏, 华健灿. 腹腔镜胃癌根治术中腹腔灌注治疗进展期胃癌的疗效观察[J]. 外科研究与新技术, 2020, 9(1): 17-19.
[12]	陈楷, 吴祖光, 姚仕伟, 邓雪涌, 刘战嬴. 非离断式Roux-en-Y吻合在腹腔镜远端胃癌根治消化道重建中的应用效果分析[J]. 外科研究与新技术, 2020, 9(1): 20-21.
[13]	堵晓英. 腹腔镜下子宫肌瘤剥除术、全子宫切除术及次全子宫切除术对患者术后卵巢功能/性功能影响的对比[J]. 外科研究与新技术, 2019, 8(4): 240-243.
[14]	彭柳花, 贾雄, 李崇彪. 复杂性肛瘘两种手术方式的临床疗效对比分析[J]. 外科研究与新技术, 2019, 8(3): 154-156.
[15]	张世杰, 方万强. 腹腔镜辅助远端胃癌根治术与开腹手术的临床对照分析[J]. 外科研究与新技术, 2019, 8(1): 7-9.